III. Hemangioma Treatment

Hemangiomas that are flat and appear reddish in color are called "superficial" and those that are deep beneath the skin and appear bluish in color are called "deep" hemangiomas.  When a hemangioma is both deep and superficial it is called a "compound" hemangioma.  The correct diagnosis is critical for proper treatment.

Hemangiomas can grow for up to 18 months and then begin a long slow regression known as involution.  This involution can last from 3- 10 years.  While all hemangiomas eventually "involute" the result is not always cosmetically acceptable.  Early intervention has been shown to reduce the need for corrective surgery after "involution" has occurred; or to, at least, minimize extensive corrective surgeries in the future.  Psycho-social scarring which occurs when a child has been forced to live with a facial deformity until "involution" has been completed can be avoided by early, aggressive intervention.

In some cases, hemangiomas can be life threatening or severely problematic (interfering with eating, breathing, seeing, hearing, speaking, etc.) and require immediate aggressive intervention.  Hemangiomas that grow internally can be very dangerous.  They are difficult to detect and when they are detected, the infant is often in need of immediate intervention.  Internal hemangiomas (referred to as visceral) occur in the liver, intestines, airway and brain. Infants who have what is referred to as hemangiomatosis ( multiple hemangiomas) are suspect for internal lesions.  When an infant has more than 3 hemangiomas, an ultrasound should be done of the entire body to rule out internal lesions.  Jaundice may be a sign of liver hemangiomas, blood in the stool may be a sign of hemangiomas on the intestines and stridor (croupy cough and difficulty breathing) may be a sign of airway hemangiomas.

The treatment can involve laser, steroids (systemic or injection), surgery or doing nothing.